Provider Demographics
NPI:1598733313
Name:SHAW, CAROLINE HESS (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:HESS
Last Name:SHAW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 9TH ST N
Mailing Address - Street 2:#300
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5820
Mailing Address - Country:US
Mailing Address - Phone:239-624-4200
Mailing Address - Fax:239-624-4201
Practice Address - Street 1:399 9TH ST N
Practice Address - Street 2:#300
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5820
Practice Address - Country:US
Practice Address - Phone:239-624-4200
Practice Address - Fax:239-624-4201
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101730363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000413800Medicaid
FLE6438WOtherMEDICARE
FLY04NSOtherBCBS
FL000413800Medicaid
FLE6438YMedicare PIN
FL000413800Medicaid